1244 Association Between Urinary Metabolites of Volatile Organic Compounds and Obstructive Sleep Apnea-Related Symptoms: Evidence from KNHANES (2020–2021)

Abstract Introduction Obstructive sleep apnea (OSA) is a widespread sleep health issue linked to factors, such as obesity; however, the role of environmental pollutants is gaining attention. We investigated the association between volatile organic compound exposure levels and OSA-related symptoms in a nationally representative sample of 759 South Korean adults (aged ≥ 40 years) from the 2020–2021 Korea National Health and Nutrition Examination Survey (KNHANES). Methods OSA-related symptoms were assessed using the first three questions (snoring, tiredness, and observed apnea) of the STOP-BANG screening tool applied by the KNHANES. The participants were grouped as symptomatic (“yes” to all three) or asymptomatic (“no” to all three). We analyzed nine urinary volatile organic compound metabolites adjusted for creatinine concentrations which were available in the KNHANES dataset. Logistic regression models were used to explore the association between these biomarkers and OSA symptoms, adjusting for covariates, including body mass index, age, sex, blood pressure, socioeconomic factors, and smoking status. Results Our analysis revealed significant sex-specific differences between groups. In men, a high concentration of N-acetyl-S-(3,4-dihydroxybutyl)-L-cysteine, a metabolite of 1,3-butadiene, was associated with increased odds of OSA-related symptoms (adjusted odds ratio = 1.005, 95% confidence interval: 1.002–1.008). This association was not statistically significant in women, possibly because of few symptomatic cases or metabolic differences. Conclusion This study provides new insights into environmental risk factors for OSA in an Asian population. Our findings suggest that exposure to pollutants, such as 1,3-butadiene, may contribute to increased OSA prevalence, particularly among men. Support (if any)